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It surprises me in today’s culture that anyone starts smoking. So much information about the harms of smoking is in the public domain that I don’t understand what motivates people to take up the habit. The most alarming and worrisome segment of the population who start is high school and middle school students. Young healthy people ignore the warnings and bow to peer pressure or simply want to appear like cool adults.

The U.S. Food and Drug Administration (FDA) and the Center for Disease Control and Prevention (CDC) conducted a survey/study called the National Youth Tobacco Survey (NYTS) to quantitate the degree to which young people use tobacco products. During a 3-month period, January – March, 2020, high school and middle school students were asked if they had used any tobacco product in the past 30 days. The results were announced in September, 2020.

There were 4.47 million youth who reported the use of e-cigarettes, cigars, cigarettes, smokeless tobacco, or Hookahs (a waterpipe for smoking) during the study period. Fortunately, that was 1.73 million fewer youth than recorded in 2019 (6.2 million used tobacco products). 

That leads to the following percentages:

     23.6% of high school students reported the use of any tobacco product

     6.7% of middle school students reported the use of any tobacco product

E-cigarettes were used the most: 19.6% of high school students used e-cigarettes

                                                       4.7% of middle school students used e-cigarettes

Cigars: 5% of high school students,  1.5% middle schoolers 

Cigarettes: 4.6% of high schoolers,  1.6% of middle schoolers

Smokeless tobacco: 3.1% of high schoolers

Hookahs: 2.7% of high schoolers,  1.3% middle schoolers

E-cigarette use on a everyday basis: 22.5% of high schoolers, 9.4% of middle schoolers

The only positive to come from this survey, is the total number of users dropped by 28% from 6.2 M in ‘19 to 4.42M in ‘20. That’s the good news. The bad news is 4.42M “kids” are using harmful tobacco products; the ones they are warned about all the time. E-cigarettes are continually portrayed as safe when they indeed are not (see Electronic Cigarettes post on DrGOpines.com). 

Messages and warnings don’t reach everybody, and some just refuse to heed the warning. However, the message needs to be presented regularly in the hope that people will begin to listen. I remember the very successful campaign to “clean up America” in the 1960’s and ‘70’s. People who who didn’t dispose of trash properly were called “Litterbugs,” and were threatened with big fines if they were caught littering. You can’t fine people for smoking, but you can show them what will happen to them physically if they continue to smoke. 

Do you remember the anti-smoking ad featuring the actor, William Talman, who played DA Hamilton Burger on “Perry Mason?” Mr. Talman tells viewers he has end-stage lung cancer from cigarette smoking and implores people to stop. When these ads were run, Mr. Talman had already died of lung cancer at the age of 53. These ads were eerie and very compelling. Here’s a man, whose face everyone recognized, telling us he had lung cancer from smoking and urging us to stop before we end up like him. It worked well, I think, but younger generations aren’t being given as compelling a message. 

If we had ads on TV for all the social ills and health problems we face today, we would have only ads on TV. Too many problems exist to mention them all. But tobacco use, like the opioid epidemic, is a big one and deserves greater emphasis. 

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